Targetoid lesions in a patient with systemic lupus erythematosus

Imtiaz, Rasheen; Hornback, Cheyenne; Eslam, Mohamed; Crowson, A. Neil; Levin, Jarad

doi:10.5070/d3272052390

Cited by 4 publications

(19 citation statements)

References 7 publications

(15 reference statements)

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“… 4 It is most commonly observed in middle-aged women (median age, 32 years), though cases in pediatric, elderly, and male patients have been reported. 1 , 5 , 6 In most cases, a history of LE precedes lesions of EM. 1…”

Section: Discussionmentioning

confidence: 99%

“…However, all versions include the presence of LE lesions (SLE, subacute CLE, or discoid LE [DLE]), the presence of EM-like lesions, and positive ANA with a speckled pattern, anti-Ro/SSA or anti-La/SSB, and RF in either the major or minor diagnostic criteria. 1 , 6 The most recent version also suggests inclusion of negative DIF on EM-like lesions. Biopsy of EM lesions demonstrates necrotic keratinocytes, although this is not specific.…”

Section: Discussionmentioning

confidence: 99%

“…1 SLE treatments include the use of antimalarials, systemic corticosteroids, steroid-sparing immunosuppressive agents such as azathioprine, MMF, or cyclosporine, or biologic agents, including anti-B cell-activating factor, anti-IL 12/23, and JAK (Janus kinase) inhibitors. 6 , 7 DLE lesion treatments include topical corticosteroids or calcineurin inhibitors, intralesional corticosteroids, and antimalarials. 8 …”

Section: Discussionmentioning

confidence: 99%

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A case of Rowell syndrome with excellent improvement following anifrolumab

Shope¹,

Andrews²,

Cunningham³

et al. 2023

JAAD Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case of Rowell syndrome with excellent improvement following anifrolumab

Shope¹,

Andrews²,

Cunningham³

et al. 2023

JAAD Case Reports

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“…There is no any standard treatment for RS 1 . The therapeutic regimen used for RS and the prognosis are similar to those of SLE or DLE that occurs alone.…”

Section: Case Discussionmentioning

confidence: 99%

“…Also, a diagnosis of RS is based on the presence of major and minor criteria, as seen in Table 2. 1,5,6,11,14 All three major and at least one minor criteria are required to confirm RS. 6 In our patient, as all the major criteria, along with one minor criterion, that is, positive RF, were present, we consider our case to be a classic RS.…”

Section: Case Discussionmentioning

confidence: 99%

Systemic lupus erythematosus associated with erythema multiforme: A rare case report of Rowell's syndrome

Bhattarai,

Sharma,

Paudel

et al. 2024

Clinical Case Reports

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Key Clinical MessageAlthough it is very uncommon, SLE may initially present with recurrent episodes of EM‐like rash. Despite the various possibilities underlying their association, prompt identification, and treatment of SLE in patients presenting with EM is important to prevent death or serious organ damage.AbstractRowell's syndrome (RS) is an uncommon presentation of systemic lupus erythematosus (SLE) with erythema multiforme (EM)‐like lesions associated with specific serological changes, including positive rheumatoid factor (RF), speckled antinuclear antibody (ANA), positive rheumatoid factor, or anti‐La antibodies in the serum. Our case, a 41‐year‐old male, presented with features of EM. Upon investigation, we identified underlying systemic lupus erythematosus, marking a rare instance of SLE presenting for the first time as EM. Classical or true EM is precipitated by trigger factors such as infective agents like the herpes simplex virus, Mycoplasma pneumoniae, drugs like anticonvulsants, antibiotics, and non‐steroid anti‐inflammatory drugs, any underlying malignancy, or connective tissue disorders, and is not associated with any specific serological abnormalities. EM cases associated with LE lesions where an EM trigger factor is missing are considered an RS diagnostic criterion. In this case report, the importance of considering SLE in patients presenting initially with recurrent episodes of EM‐like rash is emphasized. RS should be considered, especially when there is no evidence of triggering factors. Early diagnosis and prompt treatment of SLE are crucial to preventing death and irreversible organ damage.

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Systemic Lupus Erythematosus Associated with Erythema Multiforme : A Rare Case Report of Rowell’s Syndrome

Bhattarai,

Sharma,

Paudel

et al. 2024

Preprint

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IntroductionRowell's syndrome (RS) is an uncommon presentation of systemic lupus erythematosus (SLE) with erythema multiforme (EM)-like lesions associated with specific serological changes, including positive rheumatoid factor (RF), speckled anti-nuclear antibody (ANA), positive rheumatoid factor, or anti-La antibodies in the serum. Case PresentationOur case, a 41-year-old male, presented with features of EM. Upon investigation, we identified underlying systemic lupus erythematosus, marking a rare instance of SLE presenting for the first time as EM. Case DiscussionClassical or true EM is precipitated by trigger factors such as infective agents like the herpes simplex virus, Mycoplasma pneumoniae, drugs like anticonvulsants, antibiotics, and non-steroid anti-inflammatory drugs, any underlying malignancy, or connective tissue disorders, and is not associated with any specific serological abnormalities. EM cases associated with LE lesions where an EM trigger factor is missing are considered an RS diagnostic criterion. ConclusionIn this case report, the importance of considering RS as a differential diagnosis in all patients with LE exhibiting EM-like lesions is emphasized, especially when there is no evidence of triggering factors. Early diagnosis and prompt treatment are crucial to preventing complications.

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Targetoid lesions in a patient with systemic lupus erythematosus

Cited by 4 publications

References 7 publications

A case of Rowell syndrome with excellent improvement following anifrolumab

A case of Rowell syndrome with excellent improvement following anifrolumab

Systemic lupus erythematosus associated with erythema multiforme: A rare case report of Rowell's syndrome

Systemic Lupus Erythematosus Associated with Erythema Multiforme : A Rare Case Report of Rowell’s Syndrome

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